Provider Demographics
NPI:1356702963
Name:LIFE & HEALING HOMECARE LLC
Entity type:Organization
Organization Name:LIFE & HEALING HOMECARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CNA
Authorized Official - Prefix:MS
Authorized Official - First Name:DORENNA
Authorized Official - Middle Name:RENEE
Authorized Official - Last Name:WARD
Authorized Official - Suffix:
Authorized Official - Credentials:CNA
Authorized Official - Phone:513-223-2473
Mailing Address - Street 1:2206 CITY VIEW CIR
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45225-1006
Mailing Address - Country:US
Mailing Address - Phone:513-223-2473
Mailing Address - Fax:
Practice Address - Street 1:2206 CITY VIEW CIR
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45225-1006
Practice Address - Country:US
Practice Address - Phone:513-223-2473
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-09
Last Update Date:2016-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH297847404Medicaid